Confusion over Mandela's 'vegetative state'

Johannesburg: Confusion has descended over the state of Nelson Mandela's health, as the courts, his family and South Africa’s president provided contradictory assessments of the ailing leader's condition.

Doctors treating Mr Mandela said he is in a "permanent vegetative state" and have advised his family to turn off his life support machine.

Court filings related to a family dispute said the Mandela family have been advised by medical practitioners on June 26 that his life support machine should be switched off.

"He is in a permanent vegetative state and is assisted in breathing by a life support machine," said a legal filing.

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However, comments from Mr Mandela’s family and the office of South African president Jacob Zuma suggest the 94-year-old icon, who was placed in hospital on June 8 because of a persistent lung infection, is not in a ‘‘vegetative state’’.

"We confirm our earlier statement released this afternoon after President Jacob Zuma visited Madiba in hospital that Madiba remains in a critical, but stable condition,’’ the president’s office said in a statement dated July 4, using Mr Mandela’s clan name. ‘‘The doctors deny that the former President is in a vegetative state."

“Madiba is sometimes uncomfortable. Sometimes he is in pain. But he is fine,” she said.

Graca Machel spoke about her husband's condition at a fundraising drive for a children's hospital that will be named after the 94-year-old anti-apartheid leader.

"Whatever is the outcome of his stay in hospital, that will remain the second time where he offered his nation an opportunity to be united under the banner of our flag, under the banner of our constitution," she said.

Messages for Nelson Mandela are pictured outside of his Johannesburg home. Photo: AFP

Yet the court filing says Mr Mandela's health is "perilous" and he is being kept alive by life support.

"The anticipation of his impending death is based on real and substantial grounds," the court filing said.

"He's basically gone," said Charlene Smith, an authorised biographer of the former anti-apartheid leader. "He's not there. He's not there."

If Mr Mandela is using a ventilator, doctors say it would be a negative sign.

He's basically gone. He's not there. He's not there

A younger person put on mechanical ventilation — life support — can be weaned off the machine and recover, but that it can be difficult or impossible for an older person. The longer a person is on ventilation the less the chance of recovery, said the chief executive of the Faculty of Consulting Physicians of South Africa.

"It indicates a very poor prognosis for recovery because it means that he's either too weak or too sick to breathe on his own," said Dr Adri Kok, who has no connection to Mr Mandela's care. "Usually if a person does need that, any person, not keeping in mind his age at all, for any person it would be indicative of a grave illness."

"When they say 'perilous' I think that would be a fair description," she said.

In Mandela's hometown, Qunu, on Thursday, the bodies of three of his children were returned to their original resting site following the court order.

Family members and community elders attended a ceremony on the Mandela property that included the singing of hymns. The reburial took place in Qunu, where Mandela grew up and where the former president has said he wants to be buried. Forensic tests earlier confirmed the remains were those of Mandela's children.

Grandson Mandla Mandela moved the bodies to his village of Mvezo — Nelson Mandela's birthplace — in 2011. The two towns are about 25 kilometers apart. Fifteen Mandela family members pursued court action last week to force the grandson to move the bodies back to their original burial site.

Mandla Mandela — the oldest male Mandela heir and a tribal chief — told a news conference on Thursday that "my grandfather like myself would be highly disappointed in what is unraveling."

The bitter family feud comes as Mr Mandela remains in critical condition nearly a month after being hospitalised for a recurring lung infection.

Mlawu Tyatyeka, an expert on the Xhosa culture of Mr Mandela's family, said the court case over the graves was decided quickly because the family knows that Mr Mandela will soon die.

"It's not a case of wishing him to die. It's a case of making sure that by the time he dies, his dying wish has been fulfilled," he said. "We have a belief that should you ignore a dying wish, all bad will befall you."

Mr Mandela was imprisoned for 27 years during white racist rule and was freed in 1990 before being elected president in all-race elections. He won the Nobel Peace Prize along with former President FW de Klerk.